Individualized TMS Targeting via fMRI Connectivity
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Solution Overview
Problem
Current transcranial magnetic stimulation (TMS) techniques for treating depression lack precision in targeting effective stimulation sites, leading to variable clinical responses due to individual differences in brain connectivity, and existing methods fail to account for these variations effectively.
Innovation Solution
The method involves using functional connectivity magnetic resonance imaging (fMRI) to identify individual target sites in the brain, specifically in the left dorsolateral prefrontal cortex (DLPFC), which are negatively correlated with the subgenual cingulate region, to tailor TMS treatment based on each patient's unique connectivity patterns, utilizing seed maps and varying stimulation field sizes for improved efficacy.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Adaptability or versatility
If population-based TMS targeting is used, then the treatment can be applied broadly to multiple patients, but the precision and effectiveness of targeting individual brain regions decreases due to individual differences in brain connectivity
Solution Approach 1:
The patent segments the population-based approach into individualized assessments by dividing patients into subgroups based on their specific brain connectivity patterns measured through fMRI, allowing tailored TMS targeting for each patient while maintaining the ability to treat multiple patients through standardized subgroup protocols
Solution Approach 2:
The patent applies local quality by identifying and targeting specific brain regions (such as the subgenual cingulate cortex) that show abnormal connectivity patterns in individual patients, rather than using a uniform targeting approach for all patients, thereby improving treatment precision for each patient's unique pathology
2Reliability
If individualized TMS target sites are identified using fMRI functional connectivity analysis, then the clinical effectiveness and reproducibility of treatment improves, but the complexity of the treatment protocol and time required for assessment increases
Solution Approach 1:
The patent performs preliminary fMRI functional connectivity assessments before TMS treatment to identify individualized target sites, establishing the optimal stimulation parameters in advance so that the actual TMS treatment can be administered efficiently without requiring complex real-time adjustments during therapy sessions
Solution Approach 2:
The patent uses fMRI functional connectivity data as an intermediary to bridge the gap between population-based treatment protocols and individualized patient needs, providing objective biomarkers that guide target selection and reduce the complexity of clinical decision-making by translating complex brain connectivity patterns into specific, actionable TMS targeting parameters
3Ease of operation
If standard TMS coil positioning is used, then the procedure is simple and quick to administer, but the precision of targeting specific brain regions decreases leading to variable clinical responses
Solution Approach 1:
The patent transitions from static, standardized coil positioning to dynamic, individualized targeting by using fMRI-based functional connectivity data to determine optimal coil placement for each patient, allowing the targeting strategy to adapt to each patient's unique brain organization while maintaining procedural efficiency through pre-planned targeting protocols
Applied Scientific Principles
This section explains which scientific principles are used to turn an abstract innovation direction into a practical engineering solution.
Function Achieved in This Case
This approach allows for the selection of TMS targets that are more reproducible and effective across sessions, offering superior clinical outcomes compared to population-based targeting, with individualized targeting showing significant advantages, especially with more focal stimulation fields.
Implementation Method 1
Transcranial magnetic stimulation (TMS) provides a non-invasive procedure for generating magnetic fields to induce stimulating electric current to desired areas of the human body
Implementation Method 2
Resting state fMRI may be used, which is based on blood oxygenation level dependent (BOLD) signal reflecting spontaneous neural activity
Data Source
AI summary
Techniques for identifying individual target sites for application of transcranial magnetic stimulation (TMS) to a brain of a patient for treatment of neurological and psychiatric disorders. The identification of the target TMS stimulation sites may be based on using functional connectivity magnetic resonance imaging (fMRI) to determine cortex regions of the brain that are functionally connected to other regions of the brain that may be stimulated to decrease symptoms of depression and other disorders. For example, target stimulation sites may be identified in the left dorsolateral prefrontal cortex (DLPFC) to remotely modulate the activity in a subgenual cingulate region and other limbic regions functionally connected with the DLPFC. TMS may be applied to the patient's head at the identified target TMS sites to treat depression and other neurological and psychiatric disorders.